Organization Active NPI

Dr Robert N Prichep Physician PC

  • Surgery Physician
  • East Patchogue, NY
National Provider Identifier
1326288978
Registry record updated Jul 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
148405 Issued in NY
Legal business name
DR ROBERT N PRICHEP PHYSICIAN PC
Practice address
286 Sills Rd
Suite 5
East Patchogue, NY 11772-8810
Phone
(631) 654-9090
Fax
(631) 654-0265
NPI assigned
Feb 23, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Toni G Celms
Title
Billing Administrator
Phone
(631) 737-4168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 148405 NY Primary

Addresses

Primary practice location

286 Sills Rd
Suite 5
East Patchogue, NY 11772-8810

Mailing address

286 Sills Rd
Suite 5
East Patchogue, NY 11772-8810
Phone (631) 654-9090

Other identifiers 1

IdentifierTypeStateIssuer
00962092MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090227000016 NY Part B Supplier - Clinic/Group Practice 5496811424 Receives reassigned benefits from 1 practitioner
Practice locations: West Babylon, NY

National Provider Directory

National Provider Directory

Locations

286 Sills Rd
Ste 5
East Patchogue, NY 11772
Phone (631) 654-3100

486 Sunrise Hwy
Ste 2
West Babylon, NY 11704
Phone (631) 422-8520

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248825600000",
    "number": "1326288978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 SILLS RD",
            "address_2": "SUITE 5",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728810",
            "telephone_number": "631-654-9090",
            "fax_number": "631-654-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 SILLS RD",
            "address_2": "SUITE 5",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728810",
            "telephone_number": "631-654-9090",
            "fax_number": "631-654-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR ROBERT N PRICHEP PHYSICIAN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-23",
        "last_updated": "2009-07-29",
        "status": "A",
        "authorized_official_last_name": "CELMS",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "631-737-4168"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "148405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00962092",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.